目的 探讨检测血和尿中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinase-associated lipocalin,NGAL)对高血压早期肾损害的预测价值。方法 435例高血压患者按照病程长短分为长病程组及短病程组,按照分级标准分为3级;135例健康体检者作为对照组。应用酶联免疫吸附方法检测尿NGAL浓度,同时测Scr、ACR、血β2-mG及尿β2-mG。结果 高血压各级、各亚组血、尿NGAL检测浓度均高于对照组,血和尿中NGAL浓度呈正相关,尿NGAL浓度可以反映血浓度,尿NGAL高血压1级(1.21±0.63)μg/L、短病程组(2.21±1.59)μg/L均高于对照组(0.58±0.32)μg/L( P＜0.05),高血压2级(1.93±1.86)μg/L,高血压3级(3.11±1.38)μg/L和长病程组(3.29±1.41)μg/L与对照组比较,差异有统计学意义(P均＜0.01);高血压3级较高血压1级尿NGAL浓度高,长病程组较短病程组高(P均＜0.05);尿NGAL与高血压级别、高血压病程和Scr均呈显著性正相关(r=0.415、0.427、0.540,P均＜0.05),与ACR、血β2-mG、尿β2-mG相关性不明显。结论 尿NGAL可作为诊断高血压性肾损害敏感而准确的早期标志物,有望用于临床监测。
Abstract
Objective To study the role of neutrophil gelatinase-associated lipocalin(NGAL) played in hypertensive nephropathy,and to identify its clinical significance. Methods 435 patients with hypertension were divided into two groups according to their course of the diseases,and in three degrees.135 healthy people were enrolled as an observation group. We detected urine NGAL levels by enzyme linked immune absorption assay,Scr、ACR、sβ2-mG and uβ2-mG were detected,too. Results The levels of urine NGAL in all subjects with hypertension were obviously higher than in the healthy people,compared with control group(0.58±0.32)μg/L,the degree 1 hypertension(1.21±0.63)μg/L and shorter course of the hypertension (2.21±1.59)μg/L showed higher urine NGAL (P＜0.05),while the 2 (1.93±1.86)μg/L and degree 3 hypertension(3.11±1.38)μg/L and longer course of the hypertension(3.29±1.41)μg/L had higher urine NGAL(P＜0.01).Urine NGAL was significantly higher in patients with degree 3 hypertension than in patients with degree 1 hypertension (P＜0.05). The longer course of the hypertension distinctly higher than the shorter(P＜0.05),too.The concentration of urine NGAL had positive relation to degree of hypertension,course of the hypertension and Scr(r=0.415,0.427,0.540,P＜0.05),no relation to ACR、serum β2-mG and urineβ2-mG. Conclusions Urine NGAL is expected to be developed as a new biomarker to diagnose hypertensive nephropathy because of its sensitive and specific character.
关键词
中性粒细胞明胶酶相关脂质运载蛋白 /
高血压 /
高血压肾损害
Key words
neutrophil gelatinase-associated lipocalin /
hypertension /
hypertensive nephropathy
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